1174574628 NPI number — JOHN F TORREGROSA DPM

Table of content: JOHN F TORREGROSA DPM (NPI 1174574628)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174574628 NPI number — JOHN F TORREGROSA DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORREGROSA
Provider First Name:
JOHN
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174574628
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1199
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAVERNIER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33070-1199
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-853-5151
Provider Business Mailing Address Fax Number:
305-853-5788

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7867 N KENDALL DR
Provider Second Line Business Practice Location Address:
SUITE 130
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33156-7742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-274-5959
Provider Business Practice Location Address Fax Number:
305-275-0690
Provider Enumeration Date:
05/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  PO2781 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 160502400 . This is a "OWCP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 65722 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 340194400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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